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Illinois rates for HCPCS B4154

Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit

Facilitymedian $2 · 10th–90th $1–$80%10%20%10th90th$2Professionalmedian $1 · 10th–90th $1–$30%20%40%10th90th$1$0.5$2.0$10.0$50.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.07 / $1.07 / $1.07
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.02 / $3.16
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.10 / $2.29 / $8.71
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.65 / $0.79 / $0.79
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.82 / $1.82 / $1.82
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.79 / $1.23 / $8.51
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.05 / $1.05 / $1.05
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.66 / $0.66 / $0.85
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.51 / $1.20 / $2.24